What is the percentage for skin necrosis for past smokers?

Question

I quit smoking 10/26/15 and bc I did use to smoke I'm concerned about skin necrosis. I did ask my doctor but he didn't seem too concerned about it & said I've already done everything I could do by not smoking. Is there anything I can do further to lower the risks such as vitamins, etc? what exactly is the percentage or average of past smokers getting skin necrosis (like 1 in 10 or 2% out of 118,000). Any insight would greatly be appreciated!

Vincent N. Zubowicz, MD · Answer

If you have not smoke for a few months the risk of skin necrosis as part of and abdominoplasty is no different than for non-smoker.

Jaime S. Schwartz, MD, FACS · Answer

I appreciate your question.

Congratulations on quitting smoking!  I require all my patients quit smoking 8 weeks prior to surgery and 8 weeks after surgery.  It's the nicotine in the tobacco and any products that increases the risk of complications.   I would ask your surgeon if he/she would recommend you undergo a few pre-op hyperbaric treatments.

The best way to assess and give
true advice would be an in-person exam.

Please see a board-certified
plastic surgeon that specializes in aesthetic and restorative plastic surgery.

Best of luck!

Dr. Schwartz

David R. Alfonso, MD, FACS · Answer

It is great that you quit smoking, make sure you are also not using nicotine products as well. Different surgeries have different risks of necrosis but since you have been off cigarettes for close to two months your risk should be much lower. Usually I like to have patients off all nicotine at least 4 weeks prior to surgery to help lower the risk good luck

Sheila S. Nazarian, MD · Answer

I am not aware of any specific statistics on skin necrosis and smoking. The fact that you have already quite smoking and continue to remain a non-smoker is the best thing that you can do to insure proper healing post surgery. Best, Dr. Nazarian

Tania Medina de Garcia, MD · Answer

Hello dear, thanks for your question and provided information as well. I recommend you to take at least 3 oxygen treatments sessions before surgery and also, at least 6 hours after. You will be fine if you follow up those treatments.

Robert H. Hunsaker, MD · Answer

Your risk should be comparable to non-smokers at this point, unless you have been using nicotine gum/patches etc. I am unaware of anything else you can do to lower your risk at this point. Do remember, skin necrosis can still occur in non-smokers, it is simple significantly less common.

Nicholas Tarola, MD · Answer

Thank you for your question.  It is good that you realize smoking can compromise the outcomes of surgery.  It is actually the nicotine in the tobacco, or nicotine in any form including second-hand smoke, that increases the risk for complications.  Most literature recommends nicotine cessation no less than 2 weeks from the time of surgery to allow the nicotine to clear.  Nicotine cessation should continue throughout the healing process or at least 6 weeks.  Discuss this issue with your board certified plastic surgeon for his/her specific recommendations.

Gustavo E. Galante, MD · Answer

It is difficult to answer this question with accuracy, because this post-operative complication is not frequently reported or documented. Skin necrosis can vary between a small area at the wound edge, which likely heals on its own and is not of concern to the surgeon or the patient to a large area of tissue loss requiring additional surgeries. Most cautious surgeons will recommend smokng to be discontinued at least 4 weeks prior to surgery. The chances are very small that a smoking related complication will occur. The cosmetic procedures where smoking increases the risk the most are those that require raising flaps (peeling skin away from the body): facelifts, breast lifts, breast reductions, and tummy tucks for example. Congratulations on quitting your tobacco habit. It will make for a safer surgery, you will feel better, and you will have improved your overall health.

Frederic H. Corbin, MD (license restricted) · Answer

Thank you for the question and you appear to have removed the possibility of necrosis secondary to nicotine use -> Congratulations. Obviously though there are still risks with surgery without nicotine in the picture!  So pick your surgeon wiselyDr. Corbin

What is the percentage for skin necrosis for past smokers?

Answers (9)

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